PALO ALTO, Calif. -- With carefully-constructed cardboard, building materials and medical office furniture filling nearly 5,000 square feet of a formal U.S. Army drill hall in Mountain View, Calif., the site looked more like an elaborate treehouse or childhood fort. But this “treehouse” has an enormously-important mission: Change the way patient care is delivered for more than 8.7 million Veterans within the Department of Veterans Affairs.

Waves of medical professionals, architectural and construction leaders, and Veteran advisors filled the mockup at the future site of a new VA Palo Alto Health Care System building Jan. 24 to try out the computer monitor heights, see if the doors slide better to the right or left, and provide feedback on thousands of details for their new working environment.

Contracted and created by MEI Architecture, the “mockup” was part of a multi-faceted design to take the existing VA healthcare construction model that has been around since the 1940s, and update it to a streamlined design that capitalizes on the VA’s established Patient Aligned Care Team (PACT) model.

“It’s really nice to be able to try out the space before it’s built,” said VA Palo Alto Health Care System Dr. Richard Morgan, as he was writing feedback on a “sticky note” that will later be consolidated into changes. “In the end, this feedback helps with patient flow, staff satisfaction -- and most importantly, a better patient experience.”

The new design flips conventional healthcare spaces around. In the traditional model, medical providers and nurses wait in remote private offices and clinics, attempting to communicate with one another through instant messaging, emails or phone calls, while Veteran patients move to their location and often repeat their concerns several times over. In the new design, all providers, specialists and nurses work collaboratively in a “bullpen” space approximately 5-10 feet from where the Veteran patient is waiting to be treated.

“The biggest difference is in the patient experience,” said Jason Nietupski, VA Palo Alto Health Care System Director of Facility Planning and Development. “This new model means that the PACT team is working even more closely for the Veteran, delivering a ‘warm handoff’ from check-in to check-out.”

With the VA Palo Alto Health Care System’s San Jose and Monterey clinics as the first VA healthcare facilities in the nation to fully incorporate a LEAN design within the design process, Nietupski explained that is was critical to solicit as much feedback as possible in the design phase.

“This mockup is really a fantastic way to get the staff that will be doing the patient care work involved in the building process at the beginning of a design,” said VA Palo Alto Health Care System Registered Nurse Jane Rudolph-Bloom. “I can’t emphasize enough how critical this part is with ensuring the workspace is best equipped for our Veterans.”

Nietupski anticipates that this preemptive solicitation of feedback could save an estimated 5% to 7.5% of potential user-requested changes in construction costs, which could potentially save millions of taxpayer dollars. Feedback from this design will be built into a nationwide VA design guide, to be incorporated in all new construction and renovations within Veterans Health Administration. The new Monterey Joint Integrated Department of Veterans Affairs/Department of the Army Health Care Center should open by 2015, while the San Jose clinic is anticipated to be complete by 2016. Both facilities incorporate VA’s new PACT and LEAN design principles.

“Computer renderings and architectural drawings just don’t cut it when you’re talking about changing a design that has been engrained for nearly 80 years,” said Max Evans, VA Palo Alto Health Care System Project Manager. “This just takes it to an entirely new level for our Veterans.”

(From left) VA Palo Alto Health Care System Psychologist Genevieve Garratt and Dietitian Lynn McPhedran watch as Psychologist Hilary Keegan adds a feedback note regarding a new clinic design mockup. The group joined nearly 140 healthcare professionals and Veterans to “try out” a new clinic design and provide feedback that will be built into a nationwide VA design guide. (VAPAHCS Photo by Joe Matthews)

VA Palo Alto Health Care System Dr. Richard Morgan (seated) provides feedback about the durability and flexibility of a computer monitor stand during a Jan. 24 visit to a clinic design “mockup” in Mountain View, Calif., that will be built into a nationwide VA design guide (VAPAHCS Photo by Joe Matthews)

Hundreds of medical professionals, architectural and construction leaders, and Veteran advisors filled a design mockup at the future site of a new VA Palo Alto Health Care System building Jan. 24 to try out and provide critical feedback on thousands of details for their new working environment, which will later be built into a nationwide VA design guide. (VAPAHCS Photo by Joe Matthews)

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The VA Palo Alto Health Care System consists of three inpatient facilities located at Palo Alto, Menlo Park and Livermore, Calif. Also, there are seven outpatient clinics in San Jose, Capitola, Monterey, Stockton, Modesto, Sonora and Fremont, Calif. These nationally-recognized facilities provide award-winning medical care and cutting-edge technology. Along with its education affiliate at the Stanford University School of Medicine, the more than 6,200 staff and volunteers operate nearly 900 beds, including three nursing homes and a 100-bed homeless domiciliary, showing its more than 85,000 enrolled Veterans that they are “Serving those who Served.”